Dementia Flashcards
What is dementia
Impairment in at least two cognitive domains leading to significant functional decline that can’t be explained by another disorder or adverse effects of medication, these domains can be: • Memory • Language • Behaviour • Visuospatial • Executive function
What is early onset dementia?
under 65
what are irreversible causes of dementia?
- Alzheimer’s
- Diffuse vascular disease
- Lewy-body dementia
- Fronto-temporal
- Mixed
What are reversible causes of dementia?
- Subdural haematoma
- Hydrocephalus
- Hypothyroidism
What are Ix?
- Full Hx
- MMSE
- FBC
- Serology: syphilis, HIV (HIV dementia)
- CT/MRI
What legal things need to be considered for dementia?
Advance statements - what they wish to be done if they lose capacity
Advance decisions - refusing rx in future
Lasting power of attorney
what would you use to treat mild-mod Alzheimers?
Acetylcholinesterase inhibitors:
rivastigmine
donepezil
galamantine
for severe alzheimers Rx
memantine
What are the four As of alzheimers?e
Amnesia
Aphasia - always due to injury to the brain
Agnosia - inability to process sensory info
Apraxia - inability to perform learned (familiar) movements on command
What is nature of progression of vascular dementia?
Result of many small infarcts
Step wise progression, then sudden drop in function
What is the management of vascular dementia?
- Aspirin/warfarin therapy
- Control BP
- Anticholinesterases
What is the nature of Lewy body dementia?
⇒ Memory impairment later
⇒ Repeated falls, transient LoC
⇒ Parkinsonian motor features and autonomic dysfunction (postural hypotension, difficulty swallowing, incontinence, constipation)
What can treat lewy body?
rivastigmine
What is the nature of onset of frontotemporal lobe dementia?
• Tends to have an insidious onset and gradual progression
When does FTL present?
middle age
